Osteoarthritis

Osteoarthritis is a degenerative condition in which normally smooth cartilage that covers the ends of bones becomes roughened and begins to wear away. As this happens, the ends of the bones thicken and bony spurs are formed. Without healthy cartilage, the rough surfaces of bones can rub against each other and make movement painful (a sensation called crepitus). As the disease progresses, fluid-filled sacs may form in the bone near the joint. Broken off fragments of cartilage and bone may further irritate the joint space.

Osteoarthritis is the most common joint disease. Large joints are more susceptible, especially hip and knee. The spinal vertebrae and hands can also be affected.

It occurs in both men and women, most often in those over age 65. It is not necessarily a natural part of aging or a consequence of wear and tear. Factors that influence the development of osteoarthritis include heredity, overuse from work or sports, and body weight.

Symptoms

In the early stages, there may be no symptoms to warn of changes in the joints. This is partly because cartilage has no nerve fibers. The disease develops so gradually that it is well established before becoming apparent.

When they do occur, initial symptoms may be mild aching and soreness. Later, stiffness and pain in the joints is common. Pain may be sharp with movement and throbbing while at rest, or may be constant and severe.

Diagnosis

Osteoarthritis is diagnosed from evaluating age, symptoms and physical examination of the joints. X-rays, computer tomography (CT scan), magnetic resonance imaging (MRI) and blood tests may also be used, especially to rule out other problems.

While swelling, warmth, and redness are usually characteristic of rheumatoid arthritis, these symptoms do sometimes occur in osteoarthritis if the joint becomes inflamed by loose cartilage and bony fragments. A sampling of the joint fluid with a needle is sometimes done too.

Treatment

There is no known cure for osteoarthritis, but a number of effective drugs can bring relief. The treatment plan usually includes a combination of drug therapy and a balanced program of rest and moderate exercise. The goals of exercise are to maintain function by preserving range of motion and to improve muscle strength. Short periods of rest throughout the day are effective in relieving stress on damaged joints.